Compact State Nurse Licensure: An Overview

1. Compact State Nurse Licensure: An Overview

2. Objectives • Define the Nurse Licensure Compact (NLC) • Describe the purposes and goals of NLC • Discuss the benefits of compact licensure • Compare and contrast licensure under single state and the compact model • Understand NLC licensure policies

3. NLC General Purposes • Protect the public’s health & safety • Hold each party state and nurse accountable • Facilitate the exchange of information • Promote compliance with laws

4. Policy Goals of Nurse Licensure Compact

5. Mutual Recognition

6. 24 Member States

7. Concepts

8. NLC Explained on Video • http://youtu.be/KgYXULIGoa8 • www.ncsbn.org/nlc

9. Who are the NLCA? • NLC Administrator • Designated individual with responsibility for the NLC in a Compact state. • Executive Committee (Governance Structure)

10. Benefits of Compact Licensure • Nurses with a compact (multi-state) license are able to work in other compact states without getting relicensed • Facilitates mobility of nurse workforce and lawful practice • Enables the states – in their sovereign capacity- to act jointly & collectively • Facilitates continuity of care for consumers though e-health • Reduces duplicative regulatory processes

11. Compact State Licensure Important Points to Remember • Nurses are licensed in the state in which they reside (declare primary state of residence). • Only one multistate license can be held. • Compact licensure applies to RNs and LPN/LVNs and does not apply to APRNs.

12. Primary State of Residence (PSOR) Acceptable Documentation • Drivers license with home address • Voter registration card with home address • Federal income tax return declaring primary state of residence • Military Form #2058- state of legal residence certificate • W2 from US Government or any other bureau, division, or agency declaring state of primary residence

13. Application for Licensure in a Compact State Upon application for a compact nursing license, the licensing board in a party state shall search Nursys and determine whether: • the applicant has ever held, or is the holder of, a license issued by any other state, • there are any restrictions on the multistate licensure privilege, • any other adverse action by any state has been taken against the license.

14. Application for Licensure (con’t) • A nurse in a party state shall hold licensure in only 1 party state at a time issued by the home state. • A nurse who intends to change primary state of residence may apply for licensure in the new home state in advance of such change. However, new licenses will not be issued by a party state until after a nurse provides evidence of change in primary state of residence satisfactory to the new home state's licensing board.

15. Changing State of Residence • Moving between 2 party states- obtain license from the new home state; license from former home state is no longer valid; • Moving from a nonparty state to a party state- obtain license from the new home state; license from non-compact state is not affected and remains in full force if so provided by the laws of the nonparty state; • Moving from a party state to a nonparty state- license issued by the prior home state converts to an individual state license “valid only in __”, without the multistate licensure privilege to practice in other party states.

16. NLCA Policies on Licensure • https://www.ncsbn.org/1060.htm • Policy summaries follow…

17. Policy 3.1 • A license issued by a compact state limiting practice to that state (i.e., a single state license) shall be clearly identified as valid only in the that state.

18. Policy 3.2 • When a compact state verifies that a licensee has declared a non-compact state to be the primary state of residence, the former home state will remove multi-state privileges in that state's database.

19. Policy 3.3 • Licensees may hold only one active multistate RN or LPN/VN license, issued by the primary state of residence. • When a compact state issues a license to an applicant already licensed in another compact state, the new home state shall send a speed memo to the former home state notifying them that the individual has declared a new primary state of residence and has received a license in the new home state. • The former home state will invalidate the former home state license in the database • The new home state will notify the licensee that any former home state license will be made valid.

20. Policy 3.4 • Denial of licensure shall be entered into the database within 10 days. (This includes any adverse action or any action reportable to HIPDB.)

21. Policy 3.5 • A temporary permit or temporary license issued to an endorsement applicant who declares the state as the primary state of residence has multistate privileges. • Temporary permits/temporary licenses issued to a graduate of a nursing program who has not passed NCLEX is single state. • Temporary licenses/temporary permits are entered into Nursys.

22. Policy 3.6 • An international nurse on a visa applying for licensure may declare either the country of origin or the compact state as primary state of residence. If the foreign country is declared the primary state of residence, a single state license is issued.

23. Policy 3.7 • A federal /military nurse practicing on a base/VA facility, need only have one license from any jurisdiction per U.S. federal/military policy. When practicing in a civilian facility (moonlighting), nurse is bound by the Compact law and rules. • A federal/ military nurse with proof of residency in a Compact state may be issued a multistate license. If the nurse does not have proof of residency in a Compact state, nurse may be issued a single-state license . The nurse may not hold more than one multi-state license. • Standard compact proof of residency documentation applies.

24. Policy 3.8 • A licensee with a license or privilege to practice with discipline in another state may be issued a single state license in the new state of residence at the jurisdiction's discretion. • The new state of residence shall request disciplinary history and board action(s) from the state(s) where the discipline occurred. • The current state of residence may issue a single state license as indicated in Policy 3.1. • The prior state of residence shall, when requested, verify that a former licensee is eligible for an unencumbered license. Once eligible for unencumbered licensure in the prior state(s), a multistate license may be issued. • Each state will update licensure status in the database.

25. Policy 3.9 • A nurse who changes primary state of residence may practice in the new declared state on the privilege to practice granted by the former state license for a period of up to ninety (90) days from the time the new state of residence is established. • Establishment of a new state of residence is evidenced by completion of a Declaration of Primary State of Residency form. • Standard compact proof of residency documentation applies.

26. Policy 3.10 •  A multistate license shall not be issued by a compact state to anyone whose primary state of residence is another compact state.

27. Licensure Flowcharts • www.ncsbn.org/nlc

28. Thank you!